title: Increased local failure risk with prolonged radiation treatment time in head and neck cancer treated with concurrent chemotherapy.
abstract: BACKGROUND
  Prolonged radiation treatment time (RTT) in head and neck squamous cell carcinoma (HNSCC) is associated with inferior tumor control in patients treated with radiation therapy (RT) alone. However, the significance of prolonged RTT with concurrent chemotherapy is less clear.
  
  
  METHODS
  We reviewed outcomes for 171 patients with primary HNSCC treated with curative intent RT and concurrent drug therapy from 2001 to 2009. The effects of RTT and other variables on local control and survival were analyzed.
  
  
  RESULTS
  Patients with RTT >7 weeks had a significantly increased risk of local failure (hazard ratio [HR], 2.6; p = .018) and death (HR, 1.9 p = .035). These results retained significance even after adjustment for tumor stage (age was not significant).
  
  
  CONCLUSIONS
  For patients treated with concurrent chemoradiotherapy (chemoRT), prolonged RTT may compromise tumor control as has been established in the setting of RT alone. Symptoms of patients with HNSCC undergoing definitive chemoRT should be managed aggressively to limit treatment interruptions.
authors.affiliation: Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Cannon
authors.forename: Heather M
authors.initials: HM
authors.lastname: Geye
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Hartig
authors.forename: Anne M
authors.initials: AM
authors.lastname: Traynor
authors.forename: Tien
authors.initials: T
authors.lastname: Hoang
authors.forename: Timothy M
authors.initials: TM
authors.lastname: McCulloch
authors.forename: Peggy A
authors.initials: PA
authors.lastname: Wiederholt
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Chappell
authors.forename: Paul M
authors.initials: PM
authors.lastname: Harari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D016896:Treatment Outcome
keywords: accelerated repopulation; chemoradiotherapy; head and neck cancer; prognostic factors; treatment time